Ceftazidime improves hemodynamics and oxygenation in ovine smoke inhalation injury and septic shock

Maybauer, Marc O., Maybauer, Dirk M., Fraser, John F., Traber, Lillian D., Westphal, Martin, Cox, Robert A., Huda, Ruksana, Nakano, Yoshimitsu Y., Enkhbaatar, Perenlei, Hawkins, Hal K., Herndon, David N. and Traber, Daniel L. (2007) Ceftazidime improves hemodynamics and oxygenation in ovine smoke inhalation injury and septic shock. Intensive Care Medicine, 33 7: 1219-1227. doi:10.1007/s00134-007-0658-3


Author Maybauer, Marc O.
Maybauer, Dirk M.
Fraser, John F.
Traber, Lillian D.
Westphal, Martin
Cox, Robert A.
Huda, Ruksana
Nakano, Yoshimitsu Y.
Enkhbaatar, Perenlei
Hawkins, Hal K.
Herndon, David N.
Traber, Daniel L.
Title Ceftazidime improves hemodynamics and oxygenation in ovine smoke inhalation injury and septic shock
Journal name Intensive Care Medicine   Check publisher's open access policy
ISSN 0342-4642
Publication date 2007-07
Year available 2007
Sub-type Correction/erratum
DOI 10.1007/s00134-007-0658-3
Open Access Status
Volume 33
Issue 7
Start page 1219
End page 1227
Total pages 9
Editor Brochard, L.
Antonelli, M.
Place of publication Berlin/Heidelberg
Publisher Springer
Collection year 2008
Language eng
Subject 321009 Intensive Care
730110 Respiratory system and diseases (incl. asthma)
730100 Clinical (Organs, Diseases and Abnormal Conditions)
Abstract OBJECTIVE: To investigate ceftazidime in acute lung injury (ALI) and sepsis. DESIGN AND SETTING: Prospective, randomized, controlled animal study in an investigational ICU at a university hospital. INTERVENTIONS: Eighteen female Merino sheep were prepared for chronic study and subjected to smoke inhalation and septic challenge according to an established protocol. MEASUREMENTS AND RESULTS: Whereas global hemodynamics and oxygenation remained stable in sham animals (no injury, no treatment), the injury contributed to a hypotensive-hyperdynamic circulation in the control group (smoke inhalation and sepsis, no treatment), as indicated by a significant increase in cardiac index) and heart rate and a drop in mean arterial pressure. Treatment with ceftazidime (smoke inhalation and sepsis, treatment group) stabilized cardiac index and heart rate and attenuated the decrease in mean arterial pressure. The deterioration in PaO2/FiO2 ratio and pulmonary shunt fraction (Qs/Qt) was significantly delayed and blunted by ceftazidime. At 24 h after injury a significant increase in airway obstruction scores of bronchi and bronchioles in both injured groups was observed. Ceftazidime significantly reduced airway obstruction vs. control animals. Whereas plasma nitrate/nitrite levels increased similarly in the two injured groups, lung 3-nitrotyrosine content remained at the baseline level in the ceftazidime group. CONCLUSIONS: In ovine lung injury ceftazidime improves global hemodynamics and oxygenation not only by bacterial clearance but also via reduction in toxic nitrogen species such as 3-nitrotyrosine. Therefore ceftazidime appears as a clinically relevant adjunct in the common setting of sepsis-associated lung injury.
Keyword Airway obstruction
acute lung injury
acute respiratory distress syndrome
Ceftazidime/*pharmacology
Disease Models, Animal
Nitric oxide
3-Nitrotyrosine
Hemodynamics/*drug effects
Sepsis
Nitrates/blood
Nitrites/blood
Smoke Inhalation Injury/*physiopathology
Q-Index Code C1
Q-Index Status Confirmed Code

Document type: Journal Article
Sub-type: Correction/erratum
Collections: 2008 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Wed, 05 Mar 2008, 16:43:50 EST